As a CEO, practicing physician and business school professor, I have a unique perspective on the business of health care and the culture of medicine. My passion is helping people understand the interactions and consequences of these powerful forces. I am the CEO of The Permanente Medical Group – the largest medical group in the nation – and CEO of the MidAtlantic Permanente Medical Group. In these roles, I am responsible for 9,000 physicians, 35,000 staff and the medical care of 4 million Americans living on both the west and east coasts. I am chair of the Council of Accountable Physician Practices (CAPP), a board-certified plastic and reconstructive surgeon, a clinical professor of surgery at Stanford University, and on the faculty of the Stanford Graduate School of Business where I teach courses on strategy, leadership, and health care technology. I received my M.D. from the Yale University School of Medicine and completed my residency in Plastic and Reconstructive Surgery at Stanford. Follow me on Twitter @RobertPearlMD.

What Doctors Can Learn From Business Leaders

Ron Gutman of HealthTap speaks during the Digital Life Design women conference at Bavarian National Museum on June 29, 2011 in Munich, Germany. (Image credit: Getty Images via @daylife)

The first time I set foot on my medical school campus, I realized I would have to check my creativity at the door. For the majority of medical students and residents in training today, that experience remains unchanged.

The goal of medical education is to teach aspiring doctors “the right way” to provide medical care. For most patients – and for many physicians – there is comfort in the definitive answers doctors are taught to provide. But the world is changing.

Knowledge creation is speeding up and medical problems are becoming more complex. Physicians of the future will require a very different skill set and a lot more creativity.

Medical students learn by rote – memorization based on repetition. But for business students, education happens through case study, analysis and discussion.

In business school, stories about a particular company or leader force students to analyze a dilemma and provide their own solutions. Diversity of thought is valued and back and forth discussions are common. Students point to their own prior experiences and knowledge as the basis for their claims. They’re challenged by classmates to defend their solutions – and there is rarely just one right solution.

The class I teach in the business school, “Leading Strategic Change in the Healthcare Industry,” encourages students to think big and without boundaries. I spend minimal time presenting students with “the facts.” Students can read about those on their own time. Instead, students push each other to develop new ideas that could transform the health care industry.

Business students understand that the entrepreneurial path is entirely merit based. Only knowledge, hard work and creativity matter. Failure is accepted and even embraced. The heroic stories are often about people who founded several startups that went bankrupt before creating a successful one. That’s how industry-changing companies like Nike, Sun Microsystems and StubHub were formed.

Medical school couldn’t be more different. The learning process during the first two years predominantly involves memorization. One day, students memorize the bones of the wrist. The next day, they memorize the steps in the Krebs cycle. There is a solid rationale for this. Medical students need this information to provide the best care for patients. No one would be comfortable with a beginning surgeon who decides to employ a new, “creative” surgical approach that hadn’t been tested.

But the singular focus of this instruction model inhibits alternative thinking. And the hierarchical system of medical educations ensures that yesterday’s truths remain tomorrow’s answers. Failure is not tolerated, creativity is discouraged and aspiring doctors are taught to protect themselves by accepting the wisdom handed down by their professors. Medical students know they can’t go wrong by adhering to “community standards.”

The process by which professors teach medicine stifles creativity. Decades after their schooling, doctors are influenced as much by their institution as by advances in their field of specialty. Worse, this process stifles the innovative spirit required to transform health care. It is no wonder few physicians are comfortable “thinking outside the box.”

While physicians are the best people to lead transformative change in health care, few are at the forefront of today’s most influential changes in care delivery. So far, those changes have been driven by modern technology and led by contributors on the outside of medicine looking in.

An electronic medical record (EMR) example.

Electronic medical record (EMR) companies like Epic and athenahealth have transformed the way medical facilities operate. Vocera, supplier of a hands-free communication system,redefined the way thousands of nurses work. HealthTap is virtualizing care withan online platform that allows patients to ask questions to licensed physicians. These companies were founded by people with backgrounds in computer science, applied mathematics and business.

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